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Invited Critique |

Is Laparoscopic Total Gastrectomy the Right Operation?  Comment on “Laparoscopic Total Gastrectomy With D2 Lymph Node Dissection for Gastric Cancer”

Barish H. Edil, MD
Arch Surg. 2009;144(12):1143. doi:10.1001/archsurg.2009.213.
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Laparoscopic total gastrectomy for advanced gastric cancer is an approach that has been developing since 1999, when it was first described by Azagra et al1 and Uyama et al.2 In this article, Shinohara et al show an expertise and technical skill with outcomes and lymphadenectomy comparable to those of open total gastrectomies.

Laparoscopic oncologic surgery is on the rise since its equivalency was shown with colon cancer. Reported benefits with laparoscopic gastrectomies include less pain, decreased ileus, earlier recovery, decreased immunosuppression, and fewer wound complications, making it an attractive option.3,4 These benefits are seen in the early postoperative period. However, long-term quality of life has been shown to be equivalent with open gastric surgery.5

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